scholarly journals Are changes in radiological leg alignment and femoral parameters after total hip replacement responsible for joint loading during gait?

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Stefan van Drongelen ◽  
Hanna Kaldowski ◽  
Timur Tarhan ◽  
Ayman Assi ◽  
Andrea Meurer ◽  
...  
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Hip Osteoarthritis ◽  
Frontal Plane ◽  
Healthy Controls ◽  
Varus Alignment ◽  
Joint Moments ◽  
Total Hip ◽  
Leg Alignment ◽  
Shaft Angle

Abstract Background Gait kinematics after total hip replacement only partly explain the differences in the joint moments in the frontal plane between hip osteoarthritis patients after hip replacement and healthy controls. The goal of this study was to determine if total hip replacement surgery affects radiological leg alignment (Hip-Knee-Shaft-Angle, femoral offset, Neck-Shaft-Angle and varus/valgus alignment) and which of these parameters can explain the joint moments, additionally to the gait kinematics. Methods 22 unilateral hip osteoarthritis patients who were scheduled for total hip replacement were included in the study. Preoperatively and 1 year postoperatively all patients had biplanar radiographic examinations and 3D gait analysis. Results The operated leg showed significantly (P < 0.05) more varus (1.1°) as well as a larger femoral offset (+ 8 mm) and a larger Hip-Knee-Shaft-Angle (+ 1.3°) after total hip replacement; however no significant differences in the joint moments in the frontal plane compared to healthy controls were found. The hip moment (first half of stance) and the knee moments (first and second half of stance) were mostly determined by the varus/valgus alignment (29% and respectively 36% and 35%). The combination with a kinematic parameter (knee range of motion, foot progression angle) increased the predictive value for the knee moments. Conclusion In our patient group the joint moments after total hip replacement did not differ from healthy controls, whereas radiological leg alignment parameters changed significantly after the total hip replacement. A combination of these radiological leg parameters, especially the varus alignment, and the deviating kinematics explain the joint moments in the frontal plane during gait after total hip replacement surgery. For surgeons it is important not to create too much of a structural varus alignment by implanting the new hip joint as varus alignment can increase the knee adduction moment and the risk for osteoarthritis of the medial knee compartment. Trial registration This study was retrospectively registered with DRKS (German Clinical Trials Register) under the number DRKS00015053. Registered 1st of August 2018.

scholarly journals Identification of Patients with Similar Gait Compensating Strategies Due to Unilateral Hip Osteoarthritis and the Effect of Total Hip Replacement: A Secondary Analysis

2021 ◽  
Vol 10 (10) ◽  
pp. 2167
Author(s):  
Stefan van van Drongelen ◽  
Bernd J. Stetter ◽  
Harald Böhm ◽  
Felix Stief ◽  
Thorsten Stein ◽  
...  
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Secondary Analysis ◽  
Hip Osteoarthritis ◽  
Rehabilitation Program ◽  
Healthy Controls ◽  
Total Hip ◽  
Gait Kinematics ◽  
Flexion Extension ◽  
Hip Extension

Despite good clinical functional outcome, deficits in gait biomechanics exist 2 years after total hip replacement surgery. The aims of this research were (1) to group patients showing similar gait adaptations to hip osteoarthritis and (2) to investigate the effect of the surgical treatment on gait kinematics and external joint moments. In a secondary analysis, gait data of 51 patients with unilateral hip osteoarthritis were analyzed. A k-means cluster analysis was performed on scores derived via a principal component analysis of the gait kinematics. Preoperative and postoperative datasets were statistically tested between clusters and 46 healthy controls. The first three principal components incorporated hip flexion/extension, pelvic tilt, foot progression angle and thorax tilt. Two clusters were discriminated best by the peak hip extension during terminal stance. Both clusters deviated from healthy controls in spatio-temporal, kinematic and kinetic parameters. The cluster with less hip extension deviated significantly more. The clusters improved postoperatively but differences to healthy controls were still present one year after surgery. A poor preoperative gait pattern in patients with unilateral hip osteoarthritis is associated with worse gait kinematics after total hip replacement. Further research should focus on the identification of patients who can benefit from an adapted or individualized rehabilitation program.

Influence of Hip Geometry Reconstruction on Frontal Plane Hip and Knee Joint Moments During Walking Following Primary Total Hip Replacement

2019 ◽  
Vol 34 (12) ◽  
pp. 3106-3113 ◽  
Author(s):  
Felix Stief ◽  
Stefan van Drongelen ◽  
Marco Brenneis ◽  
Timur Tarhan ◽  
Benjamin Fey ◽  
...  
Keyword(s):  
Knee Joint ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Frontal Plane ◽  
Joint Moments ◽  
Hip Geometry ◽  
Total Hip ◽  
Geometry Reconstruction

scholarly journals 3D kinematic analysis of patients’ gait before and after unilateral total hip replacement

2020 ◽  
Vol 22 (2) ◽  
Author(s):  
Kateřina Kolářová ◽  
Tomáš Vodička ◽  
Michal Bozděch ◽  
Martin Repko
Keyword(s):  
Range Of Motion ◽  
Total Hip Replacement ◽  
Kinematic Analysis ◽  
Hip Replacement ◽  
Sagittal Plane ◽  
Frontal Plane ◽  
Step Length ◽  
Total Hip ◽  
Before And After ◽  
Analysis System

Purpose: The purpose of the study was to describe changes in the kinematic parameters in the patients’ gait after total hip replacement. Methods: Research group of men in the end stage of osteoarthritis indicated to the THR (n = 10; age 54.1 ± 7.5 years; weight 92.2 ± 9.6 kg; height 179.7 ± 5.9 cm). All participants underwent a total of three measurements: before surgery, 3 and 6 months after the surgery. Using the 3D kinematic analysis system, the patients’ gait was recorded during each measurement session and kinematic analysis was carried out. The parameters that were monitored included the sagittal range of motion while walking in the ankle, the knee and the hip joints of the operated and the unoperated limb, and the range in the hip joint’s frontal plane, the rotation of pelvis in the frontal and transverse planes, as well as the speed of walking and the walking step length. Results: Significant increases were found in sagittal range of motion in the operated hip joint, sagittal range of motion in the ankle joint on the unoperated side and in the walking step length of the unoperated limb. Conclusions: During walking after a THR, the sagittal range of motion in the ankle of the unoperated limb increases. Also, the range of motion in the sagittal plane on the operated joint increases, which is related to the lengthening of the step of the unoperated lower limb.

scholarly journals Long-term hip loading in unilateral total hip replacement patients is no different between limbs or compared to healthy controls at similar walking speeds

2018 ◽  
Vol 80 ◽  
pp. 8-15 ◽  
Author(s):  
John D. O'Connor ◽  
Megan Rutherford ◽  
Damien Bennett ◽  
Janet C. Hill ◽  
David E. Beverland ◽  
...  
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Healthy Controls ◽  
Total Hip ◽  
Walking Speeds

scholarly journals A Water Rehabilitation Program in Patients with Hip Osteoarthritis Before and After Total Hip Replacement

2016 ◽  
Vol 22 ◽  
pp. 2635-2642 ◽  
Author(s):  
Marek Łyp ◽  
Ryszard Kaczor ◽  
Anna Cabak ◽  
Piotr Tederko ◽  
Ewa Włostowska ◽  
...  
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Hip Osteoarthritis ◽  
Rehabilitation Program ◽  
Total Hip ◽  
Before And After

scholarly journals Joint preservation surgery: a priority to be thought of in selective hip osteoarthritis

2020 ◽  
Vol 6 (2) ◽  
pp. 404
Author(s):  
Subramaian Kanthalu Narayanan ◽  
Rajesh Sellappan
Keyword(s):  
Total Hip Replacement ◽  
Femoroacetabular Impingement ◽  
Hip Replacement ◽  
Severe Pain ◽  
Hip Osteoarthritis ◽  
Total Hip ◽  
Joint Preservation ◽  
Arthroscopic Excision ◽  
Oxford Hip Score ◽  
Acetabular Rim

<p class="abstract">Femoroacetabular impingement (FAI) is one of the causes of hip arthritis. If FAI diagnosed earlier and treated properly, arthritis of hip and eventual total hip replacement (THR) can be potentially avoided. We report 48 yr male who presented with left hip severe pain, limp, restricted movements and unable do daily day activities. He is diagnosed to have pincer type of lesion in the acetabular rim and we did arthroscopic excision of the protruding fragment. The patient now has a pain free joint and able to squat and sit cross leg. His pre-operative oxford hip score was 30 which improved to 54. </p>

Outcomes of Total Hip Replacement in Limbs Affected by Poliomyelitis

2016 ◽  
Vol 27 (2) ◽  
pp. 198-204
Author(s):  
Cesare Faldini ◽  
Marcello De Fine ◽  
Alberto Di Martino ◽  
Daniele Fabbri ◽  
Raffaele Borghi ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Hip Osteoarthritis ◽  
Lateral Approach ◽  
Harris Hip Score ◽  
Total Hip ◽  
Hip Replacements ◽  
Hip Diseases

Introduction The outcomes of total hip replacement in patients suffering from residual poliomyelitis are poorly covered in the literature. In this retrospective study we posed the question of whether total hip replacement performed for degenerative hip diseases in limbs with residual poliomyelitis could determine satisfactory mid-term clinical and radiographic results, with a reasonable complication rate. Methods A retrospective study was carried out to assess the results of 14 total hip replacements performed on 14 patients with residual poliomyelitis on the involved limb from June 1999 to September 2011. Average age at the time of surgery was 51 years (range 26-66 years). Mean duration of follow-up was 92 months (range 52-156 months). Surgery was performed through a direct lateral approach on all hips. All but one were cementless implants. Results 2 implants failed, 1 due to traumatic acetabular fracture 6 days after surgery, and 1 due to aseptic cup loosening 13 years after surgery. Surgery was uneventful in all patients except 1 (7%), who experienced a transient sensory sciatic nerve palsy. At the latest follow up Harris Hip Score was 83.3 (range 72-91) with a marked improvement when compared to preoperative score (average 52, range 32-78). No dislocations had occurred. Conclusions Total hip replacement can be considered a feasible option for hip osteoarthritis in patients with limbs affected by residual poliomyelitis. Longer follow-up studies are needed to assess the effectiveness of unconstrained total hip replacement in polio patients.

scholarly journals 338 ELDERLY MEN WITH HIP OSTEOARTHRITIS ARE FRAIL AND FRAILTY REMAINS AFTER TOTAL HIP REPLACEMENT IN THE MROS COHORT

2011 ◽  
Vol 19 ◽  
pp. S154
Author(s):  
B.L. Wise ◽  
N. Parimi ◽  
Y. Zhang ◽  
P.M. Cawthon ◽  
E. Barrett-Connor ◽  
...  
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Hip Osteoarthritis ◽  
Elderly Men ◽  
Total Hip

Is single-anaesthetic bilateral total hip replacement using cemented stems safe and appropriate? A review of four decades of practice

2018 ◽  
Vol 29 (5) ◽  
pp. 468-474
Author(s):  
John Charity ◽  
Michael C Wyatt ◽  
Simon Jameson ◽  
Sarah L Whitehouse ◽  
Matthew J Wilson ◽  
...  
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Hip Osteoarthritis ◽  
Complication Rates ◽  
Total Hip ◽  
Vein Thrombosis ◽  
Functional Scores ◽  
Lost To Follow Up ◽  
Deep Vein ◽  
Staged Operations

Background: Symptomatic bilateral hip osteoarthritis can be treated surgically with either staged or single-anaesthetic bilateral total hip replacement (BTHR). Today the typical candidate for BTHR is more likely to receive cementless implants. We present the experience of BTHR at our institution using cemented stems combined with cemented and uncemented sockets and, to our knowledge, the largest prospective single-centre series. Patients and methods: This cohort study reviews all patients (319 patients: 638 hips) having BTHR at our institution between December 1977 and December 2015. No case was lost to follow-up. Data were collected prospectively but reviewed retrospectively. Length of stay and complication rates were included, and data were compared with Hospital Episode Statistics figures for operations carried out between March 2005 and June 2014 to confirm local database validity. Patient experience and Oxford Hip Scores were obtained for a subgroup of this cohort, comparing them with patients who underwent bilateral staged operations performed within 1 year. Results: The rates for mortality, deep vein thrombosis, non-fatal myocardial infarction within 6 months were each 0.3% (1 episode) and non-fatal pulmonary embolism 0.6% (2 episodes). There were no intraoperative periprosthetic fractures or readmissions within 30 days. Conclusions: Our study shows a low risk of complications when using cemented and hybrid BTHRs for selected patients and the risk of complications compares favourably with published results. Available functional scores compared favourably to a comparison group of patients undergoing bilateral staged procedures, and a positive impression on treatment experience from a subgroup of interviewed BTHR patients was noticeable.

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